Therefore, bendamustine, an alkylating agent, was recently licensed in Europe for NHL, CLL and MM. The addition of bendamustine was able to overcome bortezomib resistance in an institutional treatment algorithm [8] in line with the observation that bortezomib enhanced the clinical activity of the alkylator melphalan in conventional doses as well as in the high dose setting [9-10]. Thus, there appears to be a rationale to combine both drugs in order to obtain clinical synergistic activity in relapsed and refractory MM patients.